4.4 Article

Orthopaedic injuries among electric bicycle users

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ELSEVIER SCI LTD
DOI: 10.1016/j.injury.2017.08.020

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Orthopaedic injury; Trauma; Bicycle; Electric bicycle; E-bike; Fractures

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Introduction: The use of electric bicycles (E-bike) has dramatically increased. E-bikes offer convenient, environmental-friendly, and less expensive alternative to other forms of transport. However, E-bikes provide a new public health challenge in terms of safety and injury prevention. This study is the first to specifically investigate the E-bike related orthopaedic injuries, based on a national trauma registry. Methods: Data from a National Trauma Registry were reviewed for patients hospitalized following E-bike related injuries. Between Jan 2014 to Dec 2015, a total of 549 patients were reviewed. Data were analyzed according to demography, type of orthopaedic injury, associated injuries and severity, injury mechanism and treatment in the operating room. Results: A total of 360 (65%) patients sustained orthopaedic injuries, out of them 230 (63.8%) sustained limb/pelvis/spine fractures. Lower extremity fractures were more prevalent than upper extremity fractures (p < 0.001). The tibia was the most fractured bone (19.2%). Patients over the age of 50 years were at the highest risk for spine (20. 5%, p = 0.0001), pelvis (15.9%, p = 0.0001) and femoral neck (15.9%, p = 0.0172) fractures relative to other age groups. Approximately 42% of patients sustained associated injuries, with head/neck/face injuries being the most prevalent (30.3%). followed by chest (11.9%) and abdominal injury (13.3%). A collision between E-bike and a motorized vehicle was the mechanism of injury in 35% of cases. In this mechanism of injury, patients had 1.7 times the risk for associated injuries (p < 0.0001) and the risk for major trauma (ISS score >= 16) was more than the double (p = 0.03). One third of patients with orthopaedic injuries required treatment in the operating room. Treatment varied depending on the type of fracture. Conclusions: This study provides unique information on epidemiological characteristics of orthpaedic injuries caused be E-bikes, pertinent both to medical care providers, as well as to health policy-makers allocating resources and formulating prevention strategies. (C) 2017 Elsevier Ltd. All rights reserved.

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